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General NPI Number Information
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NPI Number | 1275417909
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Entity Type | Individual
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Provider Name | CIARA CANNOY PHD, LP
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 8303 PLATT RD
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City | SALINE
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State | MI
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Zip | 48176-9773
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Country | US
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Telephone | 734-295-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 230 COLUMBUS DR
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City | ANN ARBOR
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State | MI
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Zip | 48103-2781
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Country | US
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Telephone | 989-965-3804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 6301019554
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301019554
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP7111
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | LP7111
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License Number State | MN
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